Bed Wetting and DDVAP (Desmopressin)

Bedwetting is not a life threatening disorder but can create havoc in the life of an individual. In most cases, children who have a bed wetting problem grow out of it with time. Some children may improve with the use of an enuresis alarm. However, in other cases, the problem of bed wetting can be severe and may warrant medications. One of the best medications to treat bed wetting today is DDAVP or desmopressin. DDAVP is actually a synthetic hormone and is very effective in the treatment of enuresis.

DDAVP is available both as a pill and as a nasal spray. It works by reducing the amount of urine produced at night. With less urine formed, the bladder remains less full and the urge to urinate disappears. DDAVP is generally used in children after all conservative approaches have been tried and failed.

DDVAP is obtainable as a nasal spray but it is currently under FDA restriction and not recommended for use in the treatment of primary enuresis.

DDAVP pill is usually taken at the lowest dose just before bed time. The dose is gradually increased every 3-4 days until the desired response is obtained. The oral pill is placed underneath the tongue where it usually dissolves very fast. One should not take the pill with a glass of water. Water should be limited at night as one is trying to prevent excess urine formation.

The side effects of DDAVP include nose bleeds, headaches and abdominal bloating. These side effects are not common but do occur in about 1-3% of children.

DDAVP is very effective in stopping night time bed wetting and is an excellent choice when one is going for a trip or to sleep over at friend’s house.

Most parents report that DDAVP immediately decreases enuresis in their child. The drug only decreases the frequency of bed wetting but does not cure the problem. Most health care professionals recommend that after a period of 1-2 months, the dose of DDAVP should be slowly decreased. However, most data indicate that relapse of enuresis is quite common when the drug is stopped or the dosage is decreased. This cycle of re-starting and tapering DDAVP usually goes on for months, before one can finally stop the drug.

Unfortunately, in some children DDAVP is used to control bed wetting for many months. In such cases, a few parents tolerate some degree of bed wetting and stop the drug cold turkey.

To ensure that DDAVP works, it is important not to give the child any fluids before bedtime. Current data indicate that DDAVP works in about 80% of children with primary enuresis.